On Tim Murphy’s Wall

Tim Murphy had a wall of his own before Donald Trump decided to save us from Mexico. He too wanted to keep people out.

The original Murphy Crusade was really governed by several simple ideas.

The seriously mentally ill were not receiving the treatment they needed. It was a national disgrace.

Many of them did not even know they needed treatment because of the brain damage caused by their illness.

Because of that efforts to tell these people that they should make decisions about their lives or that their rights were important or should be respected were irresponsible and reprehensible.

One of the primary avenues of treatment needed was psychiatric hospitalization. Not only was psychiatric hospitalization needed long term psychiatric hospitalization was needed.

When the seriously mental ill were in the community they were not likely to accept the treatment they needed so something like AOT that forced people to accept the treatment they needed to become a stable and widely used feature of the mental health system.

Anyone who says there is not enough money to do all these things is wrong. There is. We have to change the way we spend the money.

We spend way too much money on people who don’t need help. They clog the system and prevent money from going to the people who really need help. These are the “worried well” (Murphy’s illegal immigrants so to speak). If we didn’t spend so money on those people we would the money we need for those who really need help.

This travesty is condoned, sanctioned, and supported by a mental health bureaucracy that doesn’t even care about those in most need. They don’t even really talk about serious mental illness.

We need to put new people in charge who really care about the people who need help and develop a system not based on serving the “worried well.”

That in a nutshell was the Murphy Crusade. It has more than a few parallels to the Trump Crusade. This is from an earlier post comparing the two :

The parallels between the Murphy and Trump campaigns are more than instructive. Each was about a man with an outsized ego who tried to sell himself as the solution to all problems. Each was built on telling people that there anger and fear are well placed, that they had been betrayed by people who didn’t really care and only cared about there own power and position. Then they were told he can make it better. Each based their hope for success on personal attacks on the integrity and motives of those that opposed them. Neither campaign ever let the truth get in the way of them making their point. And neither of them ever missed an opportunity to get all the free publicity the press could give them.

At one time it’s success seemed inevitable and if the original version had been passed would have changed everything.

Murphy ‘s wall was not a physical thing but one based on policy and even more than that the acceptance of a radical agenda, a radical narrative which in the end would have had a greater effect even than the law.

His foundational idea was that some people are worthy of care and some are not. Consider the implications of that for a moment. It makes the value of one person’s suffering versus that of another a matter of government policy. It really means people are nothing but their diagnosis, nothing other than what they are called. For some it might mean they can’t get help. For others it probably means they can’t refuse it.

His agenda was born in the work of the Treatment Advocacy Center and Dr. Torrey. Many of Murphy’s core ideas are straight from Dr. Torrey. Much of his preaching is from the Torrey gospel.

I remember that one of my first exposures to the Treatment Advocacy Center was an article I read saying that in order to achieve minimal adequacy in its mental health system Tennessee needed to triple the amount of psychiatric beds it had without cutting down its community system. I did the math and I remember my first question was what world the people who suggested this lived in.

The answer was not in this one. Apart from a million questions about whether or not psychiatric hospitals actually helped anyone and a million questions about the trauma and harm they did to people the financial ship on psychiatric hospitalization has sailed and is not coming back. There may be some more beds here and there but psychiatric hospitalization will never be the unquestioned core of the mental health system again. It is not an evidence based practice. It is far too little bang for people who have far too little bucks.

To stay alive and to stay relevant TAC needed a conspiracy and with Rep Murphy’s help created one. The worried well were born and Samsha made a great boogeyman. The problem is now not what we can’t afford to do or what we think is the right thing to do , but that we don’t care enough to do what needs to be done. Demonize those that disagree and push forward. That was the approach.

Murphy made no sense without money and the new common sense made that possible. The money was there if we just stopped spending it on people who didn’t need it and the people in charge just didn’t care enough to do that. Taken seriously the Murphy vision is the most radical, the most violent, the most controlling and incredibly unjust proposal for mental health reform ever formulated. It is far more than a set of legislative proposals. It is a way to define reality, a way to make sense of people and life that if widely accepted and widely bought into would tragically alter the lives of untold people for a long time.

Murphy has not proposed a mechanism to kick the “worried well” out of the mental health system. He doesn’t have to. Just like Trump he doesn’t need an answer. He just needs to say that the people in charge could if they cared enough. The idea itself is so far past ludicrous that I don’t even know what to call it. The practical implications are astounding. It is probably illegal on Lord knows how many grounds and certain political death to any politician that supported it once the grand design became publicly known. I suspect even Rep. Murphy knows it is a stupid idea.

I remember reading somewhere that the fact that so many people who struggled with mental health issues had found some measure of recovery or better life was proof that we really weren’t concentrating on people with serious problems. In effect the success of the system was in some weird Murphyesque way indisputable proof of its failure.

Like Trump Murphy doesn’t need to build his wall to win. He just needs to use it as leverage to make other things seem palatable and make sense. A country in which 46 states have AOT laws needed, absolutely needed, a federal AOT law. Go figure. I still don’t understand that. State Medicaid budgets most even with the federal portion, that were swallowing their state budgets needed to start paying for extended psychiatric hospitalization. Anyone who thought the legal rights of the seriously mentally ill were important needed to shut up and realize treatment comes first. And the list goes on. Murphy was the gift that never stopped giving. In a strangely unRepublican way his answer to mental health reform was to put the federal government literally in charge of everything. His speeches remind me of Trump’s acceptance of the Republican nomination. Everything is horrible, terrible and awful and if everybody would just trust him all would be well.

The bill he wanted did not pass, but his narrative and vision is alive and well. The bill the House passed at least to some degree minimized some of the damage he tried to make. It remains to be seen what the Senate will do.

I think the votes were probably there from the beginning to pass his first bill. The chairman of the committee Fred Upton just would not let it move as originally written. He wanted something “bipartisan”. He finally wrote his own bill this year that got him what he wanted and a bill was passed. There is a Murphy Bill. Plenty in there not to like but not “the” Murphy Bill.

Regardless of his motivation in doing it Chairman Upton was at least somewhat of a brake against the nastiest of Murphy. It is unclear rather or not the Senate will even pass a bill this year. No telling what next year will bring. Upton will not be the chairman of that committe. From what I have been told the chairman slot will rotate to someone who is a close friend and supporter of Murphy. If he has to come back there will be no brake and if Trump is president….

I hope the Senate passes their bill and they stand up to Murphy in committee.

Why not fund prevention methods and outpatient treatment facilities. …the politicians method is too wait until everything is a crisis and then throw money at it the wrong way like a knee jerk reaction. …I say an once of prevention is worth a pound of cure…you can’t force people into their own recovery….just like a horse you bring to water ….it is their choice to drink the water and begin a different life of recovery.